I just signed up for health insurance today. No, it was not through Washington's health benefits exchange. I wish it had been. I had planned to enroll my husband and son through the exchange. An initial look by putting in our income showed a significant savings compared what I'm paying now for a comparable plan.
Then, I heard from my human resources director that if my company offers health insurance to my family, they will not qualify for subsidies through the health exchange.
This seemed hard for me to believe. Really? Even if our insurance is costing us almost one-third of our household income? Surely that must go against the Affordable Care Act's definition of not being affordable if it costs more than 9.5 percent of our income.
So, I set out to find an answer from the source, as they say. Now, I've called the hotline for Washington Health Plan Finder a few times, and they were always helpful and easy to reach. But here I was in a crunch to decide whether to sign up for my company's insurance, and I kept getting directed to call back later.
On Tuesday, I emailed. No response. On Thursday night, I emailed again. With 'Urgent' in the subject line. I got an email this afternoon that they will call me tomorrow. Too late. My company insurance enrollment papers are due today. Meanwhile, I continued trying to get through. Before work. During lunch. After work. No dice. I had also been searching on the state's website, and the federal website, but couldn't find an answer to my particular question.
So I called the federal hotline for signing up for the national health plan. It's really for people whose states don't have their own exchanges, but they let me ask questions anyway. Yes, a nice man named Josh told me, your husband and son can sign up through the marketplace. But can they get subsidies? He thought so, but he didn't sound too sure. I called an insurance broker. He thought so too.
Well, if that's NOT the case, someone must have reported about this, I thought. So I searched under Google News under Affordable Care Act, and spouse. Yes, Seattle Times reported this in a Q&A just last month:
"Q: My employer offers a plan, but I don’t like it. Can I buy an individual plan on the exchange and perhaps qualify for a subsidy? And what about my spouse?
A: Not likely. If your employer offers meaningful, affordable coverage, you cannot qualify for a subsidy in the exchange. A plan is considered unaffordable if the employees’ share of employee-only coverage is more than 9.5 percent of their household income or if the plan pays for less than 60 percent of covered health care expenses.
If your employer plan doesn’t cover dependents, or if the cost to cover you alone is unaffordable, your spouse could qualify for subsidized coverage in the exchange."
Well, the plan for just me is less than 9.5 percent of our household income, so I guess I'm out of luck.
What about my adult son, though?
I googled some more. And I found this, in a USA Today article last month:
"Congress defined 'affordable' as 9.5% or less of an employee's household income, mostly to make sure people did not leave their workplace plans for subsidized coverage through the exchanges. But the "error" was that it only applies to the employee — and not his or her family. So, if an employer offers a woman affordable insurance, but doesn't provide it for her family, they cannot get subsidized help through the state health exchanges."
So, I'm out of luck. I can't get insurance through the exchange even if it costs us over one-third of our household income.
It doesn't seem fair. But then, my mother's voice popped into my head. "Life isn't fair," she would always say.
Last Saturday, I stopped by a friend's house, and she was online, shopping for health insurance. She and her partner haven't had health insurance for 15 years. They've had a few medical issues come up, and when they were over, they set up plans to pay off hospital bills for years on end. They work hard. Their income level is similar to ours. But they haven't worked for anyone who offered them health insurance.
In learning that I don't qualify for subsidies under the Affordable Care Act, instead of being upset that the new law isn't fair, I can be happy that some people who really need health insurance are about to get it. And maybe, if Congress ever decides to work together again, those parts of the law that don't seem fair can be fixed.
Do you have a story about signing up, or trying to sign up, for health insurance? I want to hear it. Email me at firstname.lastname@example.org, or call me, 509-997-2512.